PORTLAND — Bridget Rauscher, the city’s Substance Use Prevention Program coordinator, is stepping into new territory.
“We are building the plane as we fly,” she said May 11 as she described a new collaboration where city paramedics are riding with the Milestone Foundation’s Homeless Outreach and Mobile Engagement, or HOME Team, and then spending time at the Oxford Street Shelter.
Under the direction of the Fire Department’s medical director, Dr. Matthew Scholl, the program allows paramedics to build trust, better diagnose which medical conditions are emergencies, and give shelter staff a better base knowledge of what clients are dealing with.
“Not everyone at the shelter is an alcoholic or drug user; we have a lot of people living in the street with cancer and diabetes,” Fire Chief David Jackson said May 11. “If we help someone whose blood sugar is low, it is an easy fix without going to the ER.”
The program may lead to cost savings by reducing trips to emergency rooms, but that is not the primary focus, Rauscher and Jackson said.
“We’ve talked a lot about why people who have access to medical care but don’t get to it; it is about trust issues,” Rauscher said.
On Monday, Oxford Shelter Executive Director Rob Parritt said he is thrilled by the pilot program.
“It’s tremendously exciting. The people who we serve who are the most vulnerable, you have to meet them where they are, which is in the street,” he said.
The paramedics will spend time riding with the HOME Team, which circulates through the city peninsula checking up on people who are homeless. HOME Team’s outreach already helps reduce trips to emergency rooms, Jackson said.
“They quickly learn who people are and know where they hang out and get to them more quickly than we can,” he said.
At the Oxford Street Shelter, used by about 220 nightly, Parritt said, paramedics will likely also provide some training and talks for staff and clients to help identify conditions, their severity and some health care basics. Jackson said improving knowledge may lead to an increase in emergency calls, but he expects those would level off through gained awareness.
Helping people with diabetes, giving blood pressure screenings and tending to wounds and abscesses are ways the paramedics will help shelter clients, he added.
“The relationship building between our departments is huge,” Parritt said. “We thought this was definitely the best way to do it. We are all on the same team, at the end of the day.”
The paramedics began riding with the HOME Team about two months before a nurse practitioner from the nonprofit Greater Portland Health also begins some shifts with Milestone’s outreach team. The ride-alongs will not be concurrent, but could allow HOME Team clients four days of access to people who can help with medical questions and conditions.
Rauscher said the pilot program idea dates to a November 2016 meeting of the city’s Overdose Prevention Project when she asked the project team what they would like to see if there was available funding.
Community outreach was an answer, but funding was still in question. Rauscher secured a $10,000 grant from the University of New England to fund the program through Sept. 30, and another $20,000 from the $50,000 her department receives from the state annually.
The UNE grant comes from its Center for Excellence in Health Innovation and was unique because it can be used for fledgling programs that may not have any evidence-based data as of yet, Rauscher said.
“I had a vision, if I could find a way to fund this, I could reach my objectives personally and personally,” Rauscher said.
Jackson expects the pilot project’s learning curve to be sharp.
“The first six months, we are going to be learning about what we don’t know,” he said.
The pilot program brings a needed change in reaching some of the city’s most vulnerable people, Parritt said.
“It is a paradigm shift that needs to happen. I just hope we are not too late,” he said.
Bridget Rauscher and Fire Chief David Jackson said May 11 that having paramedics on HOME Team shifts and at the Oxford Street Shelter will lead to better care and trust.